Citation Nr: 0826394
Decision Date: 08/06/08 Archive Date: 08/18/08
DOCKET NO. 06-34 032 ) DATE
)
)
On appeal from the
Department of Veterans Affairs Regional Office in Houston,
Texas
THE ISSUE
Entitlement to service connection for open angle glaucoma
(claimed as tunnel vision) secondary to traumatic eye injury.
REPRESENTATION
Appellant represented by: Texas Veterans Commission
ATTORNEY FOR THE BOARD
Jason Barlow, Associate Counsel
INTRODUCTION
The veteran had active military service from August 1973 to
August 1976.
This matter comes to the Board of Veterans' Appeals (Board)
from a March 2005 rating decision of the Department of
Veterans Affairs (VA) Regional Office (RO) in Houston, Texas,
which denied service connection for tunnel vision. The
veteran's condition was recharacterized in an August 2006
statement of the case as open angle glaucoma (claimed as
tunnel vision) secondary to traumatic eye injury.
FINDING OF FACT
There is no competent evidence to support a finding that the
veteran's glaucoma (claimed as tunnel vision) is related to
service.
CONCLUSION OF LAW
The criteria for service connection for glaucoma (claimed as
tunnel vision) have not been met. 38 U.S.C.A. 1110, 1111,
1131, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.304, 3.306
(2007).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
Notice and Assistance
Upon receipt of a complete or substantially complete
application, VA must notify the claimant of the information
and evidence not of record that is necessary to substantiate
a claim, which information and evidence VA will obtain, and
which information and evidence the claimant is expected to
provide. 38 U.S.C.A. § 5103(a). VA must request that the
claimant provide any evidence in the claimant's possession
that pertains to a claim 38 C.F.R. § 3159.
The notice requirements apply to all five elements of a
service connection claim; (1) veteran status; (2) existence
of disability; (3) a connection between the veteran's service
and the disability; (4) degree of disability; and (5)
effective date of the disability. Dingess v. Nicholson, 19
Vet. App. 473 (2006).
The notice must be provided to a claimant before the initial
unfavorable adjudication by the RO. Pelegrini v. Principi,
18 Vet. App. 112 (2004).
The notice requirements may be satisfied if any errors in the
timing or content of such notice are not prejudicial to the
claimant. Mayfield v. Nicholson, 19 Vet. App. 103 (2005),
rev'd on other grounds, 444 F.3d 1328 (Fed. Cir. 2006).
The RO provided the appellant with pre-adjudication notice in
November 2004. The RO provided the appellant with the notice
of the criteria for assigning disability ratings and
effective dates in March 2006, subsequent to the initial
adjudication. While the second notice was not provided prior
to the initial adjudication, service connection is denied and
no rating or effective date will be assigned. Additionally,
the claimant has had the opportunity to submit additional
argument and evidence, and to meaningfully participate in the
adjudication process. The claim was subsequently
readjudicated in an August 2006 statement of the case,
following the provision of notice regarding ratings and
effective dates. The veteran has not alleged any prejudice
as a result of untimely notification, nor has any been shown.
The notification substantially complied with the specificity
requirements of Dingess v. Nicholson, 19 Vet. App. 473 (2006)
identifying the five elements of a service connection claim;
Quartuccio v. Principi, 16 Vet. App. 183 (2002), identifying
the evidence necessary to substantiate a claim and the
relative duties of the VA and the claimant to obtain
evidence; and Pelegrini v. Principi, 18 Vet. App. 112 (2004),
requesting the claimant to provide evidence in his possession
that pertains to the claim.
VA has obtained service medical records, assisted the veteran
in obtaining evidence and provided a VA examination. All
known and available records relevant to the issues on appeal
have been obtained and associated with the veteran's claims
file; and the veteran has not contended otherwise.
VA has substantially complied with the notice and assistance
requirements and the veteran is not prejudiced by a decision
on the claim at this time.
Analysis
The claimant alleges that he experiences tunnel vision due to
glaucoma which developed due to a right eye injury he
incurred in service.
In seeking VA disability compensation, a veteran generally
seeks to establish that a current disability results from
disease or injury incurred in or aggravated by service. 38
U.S.C.A. § 1110. "Service connection" basically means that
the facts shown by the evidence, establish that a particular
injury or disease resulting in disability was incurred
coincident with service in the Armed Forces, or if
preexisting such service, was aggravated therein. This may
be accomplished by affirmatively showing inception or
aggravation during service or through the application of
statutory presumptions. Where chronicity of a disease is not
shown in service, service connection may yet be established
by showing continuity of symptomatology between the currently
claimed disability and a condition noted in service. A
veteran may also establish service connection if all of the
evidence, including pertaining to service, shows that a
disease first diagnosed after service was incurred in
service. 38 C.F.R. § 3.303.
When all the evidence is assembled, VA is responsible for
determining whether the evidence supports the claim or is in
relative equipoise, with the veteran prevailing in either
event or whether a preponderance of the evidence is against a
claim, in which case, the claim is denied. 38 U.S.C.A . §
5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).
Here, the veteran clearly incurred an injury to his right eye
in service. The service medical records indicate that the
claimant got hydraulic fluid in his right eye, which resulted
in removal of a foreign body from his right eye in April
1975. Later that month he still complained of uncomfortable
irritation in the eye. No further complaints or treatment
were noted for the right eye in service. At discharge from
service in June 1976 clinical evaluation of the right eye was
normal. Service medical records also note the veteran has
facial paralysis from Bell's palsy due to a childhood
accident.
In 1982, the veteran developed dry eye on the right side
which the claimant treated with artificial tear drops,
according to an October 2004 progress note.
A June 2005 VA medical record states that in 1995 the veteran
developed tunnel vision which was subsequently diagnosed as
primary open angle glaucoma. There are no contemporaneous
medical records in the claim file documenting that reported
history.
A June 1997 VA examination note indicated that the veteran
complained of decreased vision and haziness in the right eye
approximately two years prior. On physical examination the
claimant had visual acuity of 20/20 in both eyes with
correction. The diagnosis was refractive error, and the
examiner noted the claimant's large cup-to-disk ratio may be
an indicator of open angle glaucoma.
The veteran was diagnosed with open angle glaucoma in June
2003 in a VA clinic note. The claimant was also diagnosed
with a stable refractive error/presbyopia and lagophthalmos.
October 2004 progress notes indicate that the claimant
continued to suffer from open angle glaucoma, but there was
no complaint of pain, flashes or floaters. The examiner also
noted that the claimant was responding to Travatan. October
2004 notes also indicate the claimant had onset of dry eye
and excessive tearing in his right eye. The claimant was
using refresh tears and Travatan for treatment.
June 2005 VA medical notes state that the claimant was
suffering from open angle glaucoma and that VAMC testing
showed visual field deficits in the right eye. The veteran
was utilizing Travoprost solution, and the examiner
referenced the veteran's past eye injury and dryness of the
right eye. Subsequent VA treatment records show continued
discussion of primary open angle glaucoma.
In June 2006 the claimant underwent a VA examination for his
open angle glaucoma. The doctor noted that the claimant was
taking artificial tears for dry eyes and Travoprost eye drops
for his glaucoma. The examiner confirmed that the claimant
had a right eye foreign body removal in April 1975, but
concluded the veteran's diagnosis of glaucoma suspected in
both eyes is unlikely to be related to the right eye only
foreign body incident. The examiner noted the veteran
suffered from Bell's palsy since he was eleven years old,
which caused the claimant difficulty closing his right eye.
The examiner linked the current eye discomfort the veteran
was experiencing to his Bell's palsy, concluding that the
claimant's inability to close his right eye caused dry eye
symptoms that resulted in a foreign body sensation eye pain
with a slight decrease in visual acuity in the right eye when
keratopathy was present.
Although the veteran has argued that his current open angle
glaucoma (claimed as tunnel vision) is related to the eye
injury in service, this is not a matter for an individual
without medical expertise. See Espiritu v. Derwinski, 2 Vet.
App. 492 (1992). Thus, while the veteran's lay assertions
have been considered, they do not outweigh the medical
evidence of record, which shows that there is no relation
between the veteran's open angle glaucoma (claimed as tunnel
vision) and his service. A competent medical expert makes
this opinion and the Board is not free to substitute its
judgment for that of such an expert. See Colvin v.
Derwinski, 1 Vet. App. 171, 175 (1991).
The preponderance of the evidence is against the service
connection claim for open angle glaucoma (claimed as tunnel
vision) secondary to traumatic eye injury, and there is no
doubt to be resolved. Accordingly, service connection is not
warranted. Gilbert v. Derwinski, 1 Vet. App. At 57-58.
ORDER
Entitlement to service connection for open angle glaucoma
(claimed as tunnel vision) secondary to traumatic eye injury
is denied.
______________________________________________
RONALD W. SCHOLZ
Veterans Law Judge, Board of Veterans' Appeals
Department of Veterans Affairs